SOUTHWEST MICHIGAN CENTER FOR ORTHOPAEDIC AND SPORTS MEDICINE P
NPI 1104913094
Specialist in Saint Joseph, MI
About Southwest Michigan Center For Orthopaedic And Sports Medicine P NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHWEST MICHIGAN CENTER FOR ORTHOPAEDIC AND SPORTS MEDICINE P (NPI 1104913094) is a healthcare organization registered as a specialist in Saint Joseph, Michigan and active in the NPI registry since October 2006. The organization lists Kenneth J Edwards, Managing Partner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Southwest Michigan Center For Orthopaedic And Sports Medicine P is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
15Medicare enrollment records show 15 clinicians reassign Medicare billing to Southwest Michigan Center For Orthopaedic And Sports Medicine P, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 9 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 3
Clinicians, nearest first (15)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Southwest Michigan Center For Orthopaedic And Sports Medicine P's NPI number?
The NPI number for Southwest Michigan Center For Orthopaedic And Sports Medicine P is 1104913094. It was assigned to this organization in the NPPES registry on October 10, 2006.
Where is Southwest Michigan Center For Orthopaedic And Sports Medicine P located?
Southwest Michigan Center For Orthopaedic And Sports Medicine P is located at 183 Peace Blvd, Saint Joseph, MI 49085. The listed phone number is (269) 428-3500.
What is Southwest Michigan Center For Orthopaedic And Sports Medicine P's specialty?
The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.
Is Southwest Michigan Center For Orthopaedic And Sports Medicine P enrolled in Medicare?
Yes. Southwest Michigan Center For Orthopaedic And Sports Medicine P is registered in the Medicare PECOS enrollment system.
When is Southwest Michigan Center For Orthopaedic And Sports Medicine P's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Michigan, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Southwest Michigan Center For Orthopaedic And Sports Medicine P?
According to the CMS Revalidation Reassignment List (October 2026 release), 15 clinicians in 3 Medicare specialties reassign their Medicare billing to Southwest Michigan Center For Orthopaedic And Sports Medicine P. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Physical Therapist in Private Practice (8), Orthopedic Surgery (6) and Nurse Practitioner (1). Of these, 5 practice at this address and 9 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Southwest Michigan Center For Orthopaedic And Sports Medicine P accept?
Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Southwest Michigan Center For Orthopaedic And Sports Medicine P as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Southwest Michigan Center For Orthopaedic And Sports Medicine P was last updated on April 21, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Southwest Michigan Center For Orthopaedic And Sports Medicine P · NPI 1104913094
Specialist organization in Saint Joseph, Michigan. Organization record, active in the CMS NPPES registry since October 10, 2006.
## Identity
- **NPI:** 1104913094 (Entity type: Organization)
- **Enumerated:** October 10, 2006
- **Primary specialty:** Specialist · taxonomy 174400000X
- **Organization subpart:** No
- **Authorized official:** Kenneth Edwards, MANAGING PARTNER
## Practice location
- **Address:** 183 PEACE BLVD, Saint Joseph, MI 49085-9146
- **Phone:** (269) 428-3500 · **Fax:** (269) 429-6429
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, Michigan, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 15 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Physical Therapist in Private Practice (8), Orthopedic Surgery (6), Nurse Practitioner (1); 5 practice at this address and 9 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 21, 2009
- **Other identifiers:** Medicare UPIN F24423 (MI); Medicare ID-Type Unspecified 0N80920 (MI)
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Source: [NPI Profile](https://npiprofile.com/npi/1104913094) · Data from the CMS NPPES public registry.